Vendor Application

Business Name*

Contact Name*

Mailing Address*

Shipping Address*

Business Phone*

Cell*

Business Email*

EIN/SSTP Number*

Please select one of the following:*

Retail Store

Wholesale Distributor

Applicant Name*

Title*

Signature*

Reset

Date*

After applications are reviewed, applicant's status will be notified by email or phone.

For information on distribution or retailer opportunities, or to speak with a member of the American Wholesale Hemp™ staff, get in touch by phone at 405-604-0525 or via email through our secured contact page.